How to Cope with Diabetes

Having diabetes means serious lifestyle changes. It entails saying goodbye to eating too much sweets and drinking with the gang every weekend, and saying hello to meeting your doctor regularly, checking your blood sugar level, and perhaps, regular insulin injections. For some, these changes and adjustments may come easy, but it may be grueling and excruciatingly difficult for others.

To help us fully understand the hurdles a person with diabetes needs to overcome before fully accepting his or her condition, we’ve asked a pediatric endocrinologist, an endocrinologist, and a psychologist to shed light on how to cope with psycho-social issues in diabetes. These experts give answers on how they could help those with diabetes live a normal life and not look at diabetes as a burden or a hindrance to normal living. A diabetic patient’s family and friends also play very important roles in helping patients accept the disease by not treating them as “cripples”, but as normal persons even if they have certain limitations.

Dealing with Kids
Dr. Melinda Atienza, a pediatric endocrinologist and president of the Philippine Society of Pediatric Metabolism and Endocrinology (PSPME), is convinced that kids who are diagnosed with type 1 diabetes at a very tender age have better coping mechanisms than adults. According to Dr. Atienza, adults have more issues to “contend or to cope up with” compared to kids. And since most adults have people that depend on them, the disease may actually cause a bigger problem for their families. Children, on the other hand, are more carefree and depend highly on their guardians to help them cope with the disease.

Although these kids are more “guarded” compared to non-diabetic kids their age, Dr. Atienza believes that these children should be treated as normal as possible. Parents should not smother their diabetic kids and single them out from their healthier siblings. “Just consider these children as one of the children with no special privileges. As much as possible do not change their lifestyle, like their preferences,” Dr. Atienza reminds parents of children with diabetes. However, parents should encourage their diabetic children to exercise more or get active in sports.

Dr. Atienza further reveals that most of the young patients she sees do not experience bullying because of their diabetes. She boosts these kids’ morale by telling them that they are special in that they know more than their peers. She makes them feel that injecting insulin or checking their glucose at certain times is cool and not something to be ashamed of. She also encourages them to idolize diabetics who are well-disciplined, like Gary Valenciano.

Although acceptance will take time, Dr. Atienza assures that it will come to them. “The important thing is to make them accept that they have this problem that will not leave them,” she says. She also says that she’s not as strict with very young patients when it comes to their diet. “As they grow older and they understand, that’s the time I put them on some dietary restriction,” she explains. She’s also very pleased that schools are now teaching kids about the food pyramid and how fast foods are unhealthy.

Dealing with Diabetes in Adulthood
Dr. Regina Grace Ravara, a medical doctor and currently Dean of the College of Arts and Sciences at St. Paul University Manila, shares some of the psycho-social issues that adults with diabetes may encounter. Insights are results of her own experiences as professor in Psychology. According to Dr. Ravara, diabetes may be an economic burden due to its many complications that may require rehabilitation and hospitalization. She says that this is true especially for patients in far-flung areas, since most of the time, access to healthcare facilities in their area may not be sufficient. These patients are often required to go to the city for proper healthcare, and this will mean additional expenses for them.

Some patients may also feel depressed, especially those whose family support system is weak. These patients may feel helpless and worthless, which adds to their feeling of depression. And since diabetics adhere to a strict diet, those who break their diet rule may always have the nagging feeling of guilt.

Dr. Ravara says there are several stages that a diabetic usually undergoes before finally accepting their condition. Denial and isolation comes first, followed by anger with their condition. After some time, a patient may start bargaining with God, saying that if God takes the disease away he or she will become a better person. Depression then comes next, and finally, acceptance. “As to how long will each stage take place, depends on the coping mechanisms of the patient. Some patients may not even go through the other stages but will completely accept the condition,” she explains.

According to Dr. Roberto Mirasol, an endocrinologist and past president of the Philippine Society of Endocrinology and Metabolism (PSEM) and the ASEAN Federation of Endocrine Societies, a diabetic’s loved ones, friends and even people they work with, should always be there to help them cope with the disease. A diabetes patient’s support group can help them get through one stage to the next and finally accept their condition. “Their loved ones should be accepting of the diagnosis. Usually silo yung natatakot, they fear for their partners especially if the patient is the breadwinner,” he says.

It is also important that a diabetic’s loved ones, friends, and even co-workers, understand that diabetes does not hinder them from fulfilling their responsibilities despite some precautions. “I think the more important thing is to treat them as normal so that they don’t feel alienated or they don’t feel any different. Because the minute they have adjusted to their disease, they can perform as any normal person can,” he says. Dr. Mirasol also stresses that this will not only help boost their self-confidence, but it will also help them have a positive outlook in life. A positive outlook will mean that they will treat themselves better, be compliant with their medications, look forward to their doctors’ appointment, and regularly check their blood sugar levels.

More Programs for Education
Dr. Atienza shares that PSPME holds lay fora for parents and teachers, and for doctors and nurses as well, so that they would be more aware of the disease. She also shares that during the recently concluded celebration of World Diabetes Day, PSPME conducted a poster-making contest where young patients with diabetes participated. Dr. Atienza recalls how these children created colorful posters depicting how much they look forward to growing up and having a bright future ahead of them. This, she says, is proof that even with diabetes, these children are looking forward to a productive life ahead of them.

On the other hand, Dr. Mirasol mentions Camp Cope, a summer camp for type 1 diabetic children aged seven to 17 years old. “In camp, all are diabetics including their counselors, and some of the doctors and nurses. So they can share and learn in an environment where it’s fun,” he shares. He also adds that the Philippine Diabetes Association and PSEM have education programs where they give out reading materials for diabetes patients. They also accept referrals for those who need psychological and psychiatric help.

Words of Wisdom
According to Dr. Mirasol, there is a study that says that patients who are depressed have a harder time coping with their diabetes and end up with poor metabolic control. To avoid this, he urges diabetics to accept the disease, learn to manage their disease, follow their diet, exercise, and take medications regularly. For their loved ones, he advises them to always be there for the diabetic member of their family, but not to really smother them with too much attention.

On another note, Dr. Ravara encourages their loved ones to join organizations and support groups to help them become more aware of diabetes and how to prevent complications. She knows that proper education will aid in the coping process. “The family must also be aware of the diet regimen and exercise program so that the other members of the family can adjust to the diet or even join in the exercise program for diabetics,” she says.

Dr. Ravara also encourages people with diabetes to pray and meditate a lot. “Take time to join recollections or retreats to renew their relationship with God,” she says. She also advises diabetes patients to talk about the disease, and if there is a need to cry, just let it all out.

Acceptance of the condition, full and loving support from family and friends, and complete faith in God definitely goes a long way in coping with diabetes.